New Moms Need Love, Too

by Dr. Barrie Morganstein

As a new mom, I am learning firsthand how hard it is to take care of a baby and take care of myself (not to mention also taking care of a husband and a dog). I have always been notoriously bad at getting to bed at a reasonable hour and my baby’s arrival has made it even worse. With our little bundles depending on us, our good health is even more important; here are some things that new moms can do to manage stress and feel good:

· Get out of the house. After my baby was born, I stayed in the house a lot. Although I needed the rest and recuperation, I definitely found myself going stir-crazy. Getting out of the house -- whether its outside for fresh air or to the mall -- will do a lot to lift your spirits and invigorate you.

· Get some exercise. As hard as it is to get up off the couch and as tired as you are, get moving. Walking slowly on the treadmill, doing a light yoga class, or even just stretching in your living room, moving your body will make you feel better physically and mentally.

· Keep in contact with friends. It can be helpful to speak to your friends and commiserate about your new parenting trials and tribulations. However, it can be just as helpful to simply talk about girl-stuff. Being a mom is just one of our many roles, so we may find pleasure in discussing things other than the kids (such as what happened on The Real Housewives of New York).

· Don’t be afraid to say “no”. We often try to be superheroes and take on too many obligations. The added strain and fatigue that comes with baby care makes you more vulnerable to stress and emotional overload. Nicely explain to others why you are not able to take on a certain project – supportive people will understand.

· Ask for help. Women are capable of a lot, but even Wonder Woman had a sidekick (not to mention help from the rest of the Justice League). Don’t be afraid to ask your Superman for help with whatever you need, whether it be baby’s bedtime, laundry, bills, etc.

· Remind yourself what a great job you are doing. We are often our worst critics; chances are you are not only keeping up with your new babe, but excelling in your new role.

· Get help if you need it. If you are feeling stressed, overwhelmed, anxious, or depressed, talk to someone. Let your significant other, family member, or friends, know that you need some extra encouragement. A psychologist or counselor can also be a valuable addition to your support-network. 

Dr. Barrie Morganstein is a psychologist and new mom at Southeast Psych.  You can contact her at 704-552-0116.

Can You Hear Me Now? The Basics of Central Auditory Processing Disorders

by Dr. Barrie Morganstein

Central Auditory Processing Disorders (CAPD) is a learning disability that is not very well known and is often under-diagnosed and misdiagnosed.  CAPD is also confusing because there are many signs and symptoms that are often attributed to other disorders, especially Attention Deficit Hyperactivity Disorder (ADHD) or severe anxiety.  Below are some of the most common signs that can suggest CAPD.  An individual with CAPD may…

• have poor expressive or receptive language
• have difficulty with reading comprehension, spelling, vocabulary, and/or foreign languages
• have difficulty following long conversations
• have difficulty following verbal directions, especially when involving multi-step directions
• need extra time processing information
• have decreased comprehension in noisy environments
• have difficulty with phonics or speech sounds
• talk less than peers
•  “tune out” or seem to be in a “world of her own”
• be less social because of comprehension problems

It is very easy to determine the presence of CAPD.  Many audiologists are trained to identify CAPD.  It is also very important to consider having a psycho-educational assessment completed by a psychologist to rule out the presence of other issues (e.g., ADHD, anxiety, other learning disabilities, etc.).  These professionals are also likely to help you determine the best approaches for intervention.  Some excellent books about CAPD are When the Brain Can’t Hear: Unraveling the Mystery of Auditory Processing Disorder – Teri J. Bellis, Ph.D. and Like Sound Through Water: A Mother’s Journey Through Auditory Processing Disorder by Karen J. Foli & Edward M. Hallowell.  

Dr. Barrie Morganstein is a psychologist at Southeast Psych who sees a wide range of clients and has a specialty in the assessment and treatment of central auditory processing disorders.

Parenting Stress: How to Take Care of Yourself

by Dr. Amanda McGough

You know the saying, “If mama isn’t happy then nobody is happy.” There is some truth to this old adage and it applies to fathers too. It’s easy for parents to focus all of their attention and energy on their children and family and neglect to take care of themselves. However taking care of yourself is just as important as taking care of your family. It’s a lot like the emergency landing instructions that you get on airplanes. You have to put your own oxygen mask on first in order to be able to help others. Here are some tips for taking care of yourself.

1) Do one thing every day that makes you happy. You deserve and need time for your own enjoyment. Carve out at least 15 to 30 minutes a day where you are doing something that you enjoy that’s just for you.

2) Know your limits and stick to them.  It is okay to multitask sometimes, but we also need to know when enough is enough. Cut back on things that aren’t necessary and make your life more manageable.

3) Practice what you preach. You help your kids eat a balanced diet, get enough sleep, encourage them to be physically active and take care of any illnesses they have. You need to take care of your physical needs as well. Poor nutrition, sleep deprivation, lack of physical activity and illness are all vulnerability factors to stress.

4) Put things in perspective.  It’s easy to get caught up in the day to day and think that everything is important. Step back and take a look at what really matters to you. This will help you let go of little stressors and annoyances and instead focus on the big picture.

5) Remember you are a role model.  By taking good care of yourself and managing your own stress you are setting a positive example for your children. Good self-care brings happiness to the whole family.

Dr. Amanda McGough is a licensed psychologist with Southeast Psych in Charlotte. She treats children, adolescents and adults.

Is Recovery From an Eating Disorder Possible?

by Heidi Limbrunner, Psy.D., ABPP

In working with families that have a loved one struggling with an eating disorder, one of the most common questions asked is about recovery. Can a person truly recover? 

The short answer to this question is: Yes, a person can fully recover with appropriate treatment. Research has demonstrated that while some people may struggle lifelong with an eating disorder, a majority of people can make a full recovery.

Here are four factors that can help lead to a full recovery:

1. Early Detection. Like other illnesses, the sooner a person begins treatment, the better likelihood of recovery. The longer a person engages in eating disorder symptoms, the more difficult the recovery can be.

2. Treatment Team Approach. Since eating disorders are complex illnesses that involve both medical and psychological issues, treatment should involve a therapist, physician and dietician. All of your care providers should have experience in treating eating disorders.

3. Type of Therapy. There are many different types of therapy for eating disorders. Choosing a therapy supported by research promotes the best chance for recovery. For children and teens, this therapy is called Family Based Treatment or the Maudsley Method. For adults, Cognitive Behavioral Therapy is the treatment of choice.

4. Appropriate Level of Care.  It’s imperative that a person receive care at the most appropriate level based upon their symptoms. This can be outpatient, day treatment or inpatient care. Your treatment providers should help you determine which level is appropriate.

Intervening early with a treatment team approach using a proven and research-supported therapy model at the appropriate level of care increases a person's chances of a full recovery from an eating disorder.

Dr. Heidi Limbrunner is a licensed psychologist with Southeast Psych in Charlotte. She specializes in the treatment of eating disorders.  You can contact her at 704-970-4791.

Sports Injuries Don’t Just Hurt the Body

by Dr. Nyaka Niilampti

Most of us who play a sport consider “athlete” as one aspect of our identity.  How important playing a sport is to us can greatly affect how we deal with an injury.  While healing the body is important, the injury to our identity as an athlete can be equally significant.  Some of the possible psychological impacts of sport injuries include:

Temporary loss of identity:  Many athletes connect the way people view them (popularity, respect) to their role in sport.  During the rehabilitation process, there may be a constant comparison to things that they could do, and the way that others used to view them.  These negative thoughts may work against them in their efforts to heal the body.

Feelings of isolation and being left out:  Athletics presents an important social role, and as a result, injured athletes may feel left out of the interaction with teammates, both competitively and informally.  This loss may be as significant as what we would consider a true “loss” such that a grieving process may take place. This will be especially true in the situation of a career ending injury.

Decrease in self-esteem:  For many athletes, self-esteem is connected to performance ability and achievement.  Injury for some athletes may have a significant impact on self-image and long term goal achievement.  This decrease in self-esteem may carry over into academic performance and personal relationships. 

Depending on the severity of the injury, other possible psychological impacts include anger, guilt, post-traumatic stress disorder, helplessness, and depression.  Each of these concerns may contribute to an athletes’ ability to recover well and return to post injury performance, which again can result in depressive symptoms and repeat the psychological pattern.

Here are a few things that parents and coaches can do to help injured athletes heal their minds. 

* Help athletes to acknowledge and recognize the trauma and loss that has occurred, and provide support as they experience the grieving process.  Athletes (and even coaches) sometimes engage in denial regarding the true impact of a sports injury.  This denial can result in additional injuries or negative psychological impacts.

* Provide encouragement and support during the rehabilitation process.  Due to many of the psychological impacts of sport injury, athletes may not be as motivated to engage in the rehab process.  Providing support and acknowledging the barriers may be helpful.

* Normalize their experiences of fear of re-injury.  Athletes may be apprehensive to express their concerns and fears.  Allow them to recognize that fear is a normal reaction, and that they are not alone in that experience. 

* Particularly for career-ending injuries, help athletes re-orient to alternative options.  Many athletes, particularly those who have been playing sports since early childhood, have not had the opportunity to fully develop other identities and options.  Exposing them to those possibilities is important in helping them to feel as though they have a path and some direction. 

* Finally, some athletes have such a difficult experience following a sport injury that counseling or professional support may be necessary.  Keep an eye out for signs of more significant psychological concerns such as increased isolation, poor concentration, changes in appetite, and feelings of hopeless or worthlessness.  These signs indicate that there is a need to go beyond the training room in the healing process.   

Dr. Nyaka Niilampti is a licensed psychologist at Southeast Psych with a Ph.D. in counseling psychology and a master's in sports psychology.  She sees clients of all ages and specializes in performance enhancement, relationship concerns, diversity issues, and the treatment of anxiety and depression.  She can be contacted at 704-552-0116.

Helping Your Teen Through Dialectical Behavior Therapy (DBT)

by Dr. Amanda McGough

Many of us know, or remember from our own teen years, that being a teenager isn’t easy.  Developmentally, adolescence is a time of growing independence, developing a sense of self, learning to navigate social relationships, and increasing responsibility.  On top of these developmental tasks, teens face pressures from school, peers and family responsibilities.  Teens can be under a significant amount of stress and that requires them to find ways to cope.  

Some teens may lack adequate coping skills, which leads to trying to cope with their stress in unhealthy, even harmful ways.  For example, they may have difficulties with self-injurious and life-threatening behaviors, suicidal ideation, poor impulse control, running away, stealing, lying, low frustration tolerance, interpersonal conflict, poor sense of self, high-risk sexualized behaviors, disordered eating, and substance abuse.  

However, the problems that teens face can be successfully navigated if they have healthy coping skills and support from caring adults.  Dialectical Behavior Therapy (DBT) is a form of therapy that has been widely researched for approximately 30 years.  It has proven to be effective in helping teens to reduce risky behaviors, manage emotions more effectively, create a more balanced life, and improve the overall quality of life.

What coping skills can DBT teach your teen?  DBT focuses on skills in five main areas:

1)    Mindfulness: Learning how to be focused in the present moment, how to balance emotions with rational thought and how to do what is effective in the moment.

2)    Distress Tolerance: Developing skills to help teens cope with stress in healthy ways through distraction, self-soothing and looking at the pros versus cons of choices in each situation.

3)    Emotion Regulation: Helping teens better understand emotions, reduce the intensity of their emotions, and learn how to ride the wave of emotions without acting out on them.

4)    Interpersonal Effectiveness: Developing strong relationship skills, learning how to communicate and listen in a way that is respectful towards others and themselves, learning how to say no, how to deal with difficult people and how to repair relationships.

5)    Walking the Middle Path: Learning how to validate one’s self and others, how to find the kernel of truth in different points of view, create a more balanced way of thinking and living, and how to reinforce behaviors in both self and others.

Learning effective, healthy coping skills now can benefit teens in their present life and in the future.

Dr. Amanda McGough is a psychologist at Southeast Psych who specializes in using DBT.

Top 10 Things that Make for a Stellar Psycho-Educational Assessment

by Dr. Kyra Grosman 

As kids head back to school, we start to notice some struggle to learn more than others. Parents who take a closer look can make a big difference in the childrens’ education. Psychologists can give parents peace of mind through a psycho-educational assessment to help figure out why a little boy or girl is struggling in school. Such assessments or “testing” can help kids learn more effectively.

Not all assessments are equal. A good assessment should do the following:

1) Provide a neurodevelopmental profile, and not a label. Just giving a child a label is not helpful. It’s too easy to say that a child who struggles with reading has a Reading Disorder. That label doesn’t really tell us why the child has difficulty in that area. It’s really more important to figure out why he or she is struggling in a particular area. Is reading difficult for a learner because of weak active working memory (the size of a person’s mental desk) or because they struggle with phonological processing (oral language function involving identifying, distinguishing, and manipulating the individual sounds in words)? Obviously, different learning profiles are going to be helped by different strategies which should be designed by a good assessment.

2) Must include strengths as well as weaknesses. Too many kids who struggle in school don’t get to hear enough about the awesome tasks they can complete. These strengths need to be incorporated into the feedback session, so kids, parents, and teachers have a realistic sense of hope.

3) Assessments should incorporate multiple sources of information. They should include a broad range of qualitative information (review of work samples, interview with students, information gleaned from discussion with parents and teachers), integrated with quantitative information (such as one gets from psycho-educational tests). The person writing the report must look for a pattern of strengths and weaknesses that emerge across several tests.

4) The feedback provided should give both you and your child a much clearer understanding of what’s causing his or her difficulties in school. Students need to be given age-appropriate feedback about how they learn.

5) Must include specific learning strategies based on each child’s individual profile. This should include a customized learning plan. Avoid clinicians who provide boiler plate learning plans. If they’re giving boiler plate learning plans, they’re probably not really understanding the unique aspects of your child, and they’re not helping you, either.

6) The feedback must connect neurodevelopmental function and academic skills. It should explain why Johnny can’t read and why he’s so good at math.

7) For public school children, assessment should not be so focused on determining eligibility for services that the child’s profile isn’t revealed.

8) The process of assessment should be an ongoing process of consultation. The goal is to find strategies for better success. There’s the need for on-going follow-up and tweaking of strategies as needed. Your assessor should be available to help you with this process and make sure that you, your child, and the school stay on track.

9) It’s great when the assessor can provide feedback directly with the child’s school—their teachers, learning support teachers, school psychologist, etc. This helps ensure that everybody is on the same page and allows for brainstorming what is feasable within a particular school.

10) Prioritization of weaknesses. If a child has several weak areas, it can be overwhelming to try to address them all. A good assessment should let you know what are the really important areas to address first.

And another for good measure...Make sure the report has clear explanation of the technical jargon.  It's especially helpful if it uses metaphors to help explain the concepts.

Dr. Kyra Grosman is on staff at Southeast Psych and we think she does stellar psycho-educational assessments.  She also sees clients for therapy for a range of issues.